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· DOS Abstracts
One-year follow-up after ACL reconstruction –
surgeon or physical therapist ?
Ina Wieland Nielsen, Kirsten Bettina Jensen, Jonathan Jetsmark Bjerre, Peder
Klement Jensen, Michael R. Krogsgaard
Ergo- and Physical Therapy, Bispebjerg Hospital; Section for
Sportstraumatology M51, Bispebjerg Hospital; Dept. of Orthopadic Surgery,
Bispebjerg Hospital
Background:
One year follow-up after ACL reconstruction is traditionally done
by orthopaedic surgeons, often the person who operated, which could lead to
bias in the results. One year is also time for return to sports, and patients often
request instruction for further rehabilitation.
Purpose / Aim of Study:
To replace surgeons with physical therapists (PTs) at
one-year follow-up and evaluate if stability measures changed.
Materials and Methods:
Between 1.5.13 and 30.4.14 (P2) one- year fol-
low-up of patients after ACL reconstruction were done by one of two specially
trained PTs and only by a surgeon if problems were reported. Stability measures
including Lachman-, drawer- and pivot-tests and anterior laxity with Rolimeter
in both knees were performed. In addition 4 functional tests were done. The
same stability measurements were performed by the surgeons in a previous pe-
riod: 1.5.12 – 30.4.13 (P1), and results for the two periods were compared.
Findings / Results:
Rolimeter measures right/left were 5,63/5,79 mm in P1
and 6,96/7,07 mm in P2. Measures were significantly higher for both knees
in P2 (t-test: p < 0,001). The difference between operated and non-operat-
ed knee in P1/P2 was 1,38/1,98 mm (p = 0,008). There were more positive
drawer tests (p = 0,005) during P1, but no difference for Lachman and pivot-
tests (p > 0,05). Standard rehabilitation plans (GOPs) had been sent to the local
therapists following reconstruction, but the content of the actual rehabilitation
varied and many patients asked for further instruction.
Conclusions:
Absolute measures and differences in Rolimeter measurements
were higher during the period when PTs tested, indicating that PTs and surgeons
might test differently. An advantage of PT follow-up is the possibility for further
instructions, functional testing results and release of surgeons’ time.
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